Magnetresonanztomografie mit superparamagnetischen Kontrastmittel: Ergebnisse und Anwendungsempfehlungen bei Patienten mit hepatisch metastasiertem neuroendokrinen Tumor

Neuroendokrine Tumoren des Gastrointestinaltraktes sind eine seltene, zumeist langsam progrediente Erkrankung,die zum Zeitpunkt der Diagnosestellung bereits bei etwa der Hälfte der Patienten hepatisch metastasiert hat. Eine sichere und genaue Diagnostik zur Abklärung einer Lebermetastasierung ist de...

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Bibliographic Details
Main Author: Fischer, Tobias
Contributors: Klose, K.J. (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2005
Online Access:PDF Full Text
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The aim of this prospective clinical trial was to compare the diagnostic performance of unenhanced and Gadolinium-enhanced (Gd-DTPA) MR imaging versus superparamagnetic iron oxide(SPIO)-enhanced MR imaging for detection of liver lesions in patients with neuroendocrine tumors. 44 patients underwent unenhanced and Gd-enhanced MR imaging of the liver at day one and SPIO-enhanced MR imaging at day two on a 1T MR machine.In 37 of 44 patients 316 suspect liver lesions with unenhanced and Gd-enhanced MRI versus 536 suspect lesions with SPIO-enhanced imaging were detected. This corresponds to an increase of detectable lesions of about 70% only achievable with a combination of four sequences (SPIO sequences: T2 turbo spin-echo; T2* gradient-echo fatsaturated; T1 gradient-echo fatsaturated; T1/T2 TrueFISP fatsaturated). There was no further lesions characterization,e.g. "benign" or "malign", as the specific dignity of the lesions was not proven.SPIO-MRI yields additional information relevant for decision making and patient selection in oncologic surgery. Alike literature reports minor adverse effects to SPIO occurred in almost 11,4%.